SPRING BREAK CAMP Registration Form

SPRING BREAK CAMP Registration Form

Welcome! If you would like to take part in Spring Break BASKETBALL CAMP, please fill in your details in the form below and you will be automatically registered.
Athlete Information
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Gender
T-Shirt Size
Choose the camp you want to attend
Parent/Guardian Information
Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Payment Method
Photo and Testimonial Consent:
I hereby grant permission to Triumph Sports Academy and the UNBC Athletics and Recreation department the irrevocable and unrestricted right to use, re-use, and/or publish my child's name, testimonial, and/or photographs as taken to promote and support the program. By checking the mark, I represent that i am a legal parent/guardian and that i give consent to use my child's name, testimonial, and/or photographs in any and all material, print or electronic and I wave the right to inspected/or approve the finished product in which my child's name, testimonial, and/or photographs will be published.
BC Freedom of Information and Protection of Privacy Act (FOIPP):
Checking "Accept" below, I consent to having the information this document collected by Triumph Sports Academy and the University of Northern British Columbia. The personal information requested on this form is collected under the authority of University Act and Section 32(c) of the FOIPP Act and this information will only be used for the purpose for which it's intended. Certain personal information may be made available to federal and provincial departments and agencies under appropriate legislative authority. Personal Information is protected under the BC FOIPP Act.
Emergency Information
Participant's Care Card #
Emergency Contact Name

First NameLast Name
Emergency Contact Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the athlete prescribed an inhaler? If yes, please explain any instructions.
Medical Release and Authorization

1. I hereby give consent to, and authorize, emergency medical and/or dental treatment during my son or daughter's involvement in the Junior Timberwolves Program or such period reasonably related there to.
2. I hereby consent to the release of medical information to the Junior Timberwolves' Coaching Staff in event of injury or other medical emergency.
3. I hereby acknowledge that no treatment or procedure referred to above will be administrated to except with the same limitations and conditions contained therein.
4. I hereby confirm that this not a power of attorney for personal care.
Date

MonthDayYear
Date
Should be Empty: